ScienceSeptember 16, 20263 min read

Dropping to a lower tirzepatide dose kept much of the weight off, a new trial finds

In a year-long trial, adults who stepped down from 10 or 15 mg of tirzepatide to 5 mg ended 16.6% below their starting weight, against 21.9% for those who stayed on their dose and 9.9% for those switched to placebo.

What happened

SURMOUNT-MAINTAIN, published in The Lancet in June 2026 and funded by Eli Lilly, followed 441 adults with obesity in the United States. They first took tirzepatide at the highest dose they could tolerate, 10 mg or 15 mg, for 60 weeks. Then 378 of them were randomly assigned for another year to stay on that dose, drop to 5 mg, or switch to placebo.

At week 112, compared with where they started:

those who stayed on their dose were 21.9% lighter
those who dropped to 5 mg were 16.6% lighter
those switched to placebo were 9.9% lighter

From week 84, anyone who regained more than half of the weight they had lost could have tirzepatide back. That happened to 8% of people on their full dose, 25% on 5 mg and 67% on placebo.

What it means

A lower dose sat between the two alternatives. It kept a good share of the weight off, but not as much as staying on the full dose, and a quarter of people on it regained enough to need rescue treatment. The authors describe 5 mg as a possible "valuable alternative to discontinuation", and say responses may vary between people.

What it does not answer

The trial tested 5 mg, the lowest licensed maintenance dose of tirzepatide. It says nothing about the smaller "microdoses" discussed online, nothing about semaglutide, and nothing beyond one year at the lower dose.

For the full picture, including what stopping does and what to agree with your prescriber before stepping down, read staying on a lower GLP-1 dose.

Recipes that fit

Each with a stated portion and its nutrition calculated from the ingredients.

Halibut with warm lentils, tomato and parsley48 g protein · 18 g fibre · 475 kcal
Chicken and squash traybake with sage and haricot beans47 g protein · 12 g fibre · 500 kcal
Chicken, celery and butter bean soup with rosemary47 g protein · 12 g fibre · 505 kcal
Chicken, leek and tarragon with pearl barley47 g protein · 10 g fibre · 525 kcal

See all 177 high-protein GLP-1 recipes

Go deeper

Staying on a lower GLP-1 dose: what the first maintenance trial foundRead What happens when you stop a GLP-1, and how to plan for itRead GLP-1 microdosing: what it means, what the evidence shows, and the real risksRead

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